Mental Health and Substance Abuse Programs in alphabetical
Mental Health and Substance Abuse Programs in alphabetical
Mental Health and Substance Abuse Programs in alphabetical
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DEPARTMENT OF HEALTH SERVICES<br />
Division of Quality Assurance<br />
Pr<strong>in</strong>t Date: 08/28/2012<br />
Page 24 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
1335<br />
AURORA BEHAVIORAL HEALTH - NORTH SHORE<br />
KATE CONNELLY<br />
6980 N. PORT WASHINGTON, #202<br />
MILWAUKEE, WI 53217<br />
County: Milwaukee<br />
kate.connelly@aurora.org<br />
Phone: (414) 454-6506<br />
Fax: (414) 454-6450<br />
Surveyor: William Goehr<strong>in</strong>g<br />
Services<br />
Community <strong>Substance</strong> <strong>Abuse</strong> <strong>and</strong> <strong>Mental</strong> <strong>Health</strong><br />
Program Certification Directory<br />
By Provider Name & Certification Number<br />
Initial Certification/<br />
Certification Effective/<br />
Certification Expires<br />
08/01/1985<br />
08/01/2012<br />
07/31/2014<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
CSAS-Outpatient Treatment DHS 75.13<br />
1386<br />
AURORA BEHAVIORAL HEALTH CENTER -<br />
MANITOWOC<br />
SOUMIT PENDHARKAR<br />
5300 MEMORIAL DRIVE<br />
TWO RIVERS, WI 54241<br />
County: Manitowoc<br />
No Email Address Provided<br />
Phone: (920) 793-7420<br />
Fax: (608) 793-7391<br />
Surveyor: Frank Bellaire<br />
Services<br />
STATE OF WISCONSIN<br />
Bureau of <strong>Health</strong> Services<br />
PO Box 2969<br />
Madison, WI 53701-2969<br />
Tier/<br />
Branch Beg<strong>in</strong>/<br />
Branch Location(s) End Dates<br />
AURORA BEHAVIORAL HEALTH -<br />
HARTFORD<br />
1640 E SUMNER STREET<br />
WEST BEND, WI 53095<br />
AURORA BEHAVIORAL HEALTH - WEST<br />
BEND<br />
205 VALLEY AVENUE<br />
WEST BEND, WI 53095<br />
Tier 1<br />
08/01/2012<br />
07/31/2014<br />
Tier 2<br />
08/01/2012<br />
07/31/2014<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
09/01/1993<br />
04/01/2012<br />
03/31/2014<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
1839<br />
AURORA BEHAVIORAL HEALTH CENTER - SINAI<br />
KATE CONNELLY<br />
1020 N 12TH STREET, 4TH FLOOR<br />
MILWAUKEE, WI 53233<br />
County: Milwaukee<br />
kate.connelly@aurora.org<br />
Phone: (414) 219-5000<br />
Fax: (414) 219-5422<br />
Surveyor: William Goehr<strong>in</strong>g<br />
Services<br />
NO BRANCH LOCATIONS<br />
08/01/2012 07/31/2014<br />
08/01/2012 07/31/2014<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
10/01/1987<br />
01/01/2012<br />
12/31/2013<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
CSAS-Outpatient Treatment DHS 75.13<br />
NO BRANCH LOCATIONS<br />
04/01/2012 03/31/2014<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
01/01/2012 12/31/2013<br />
01/01/2012 12/31/2013
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